Empowering voices in podiatry. Speak up week in Scotland 2023

Speaking up in NHS Scotland has never been more important. The current media about the Lucy Letsby case, or the latest report by the Royal College of Surgeons on sexual misconduct, are alarming reads showing the system at its worst, and at the extreme end of concerns raised about patient care, wrongdoing and malpractice.

Every day staff raise concerns within their workplace: they are dealt with, investigated and closed off. However, we must acknowledge that not all concerns are brought to managers or clinical leaders. Staff feeling fear, anxiety and uncertainty about what will happen if they do.

This year’s Speak Up Week Theme is "Learning from Concerns". We cannot underestimate the importance of creating the conditions to support staff to feel safe to raise concerns, and learning, when they do.

My experience has come from many years as a RCPod Trade Union and Health and Safety rep supporting staff, hearing their concerns and what barriers prevented speaking up. As the rep I was clear about the policies and procedures in place aligned to many of the concerns. Within the area I worked, there was always a feeling of being heard and listened to if I had something to raise myself.

That changed when I had to raise a concern about patient safety issues.  I witnessed this while out on a care home visit and observed a patient being inappropriately treated by care home staff, abusing their position and having no regard to the patient’s dignity, safety or care needs.  It was a horrible thing to witness and despite all my understanding of policies, having completed my protection of vulnerable adults training, my experience of escalating this was difficult. I felt unheard and not supported in the way I should have been. 

I had to report this formally to the care home manager and the Care Commission and, go through the steps for an investigation. This was hard but what I was unprepared for, was the lack of support from my team. My usual manager was off and when I explained the event to my interim manager their response shocked me. After explaining what had happened, they wanted to know if I would be finishing my dom journey. I was not asked if I was ok. I wasn’t - I was in tears in a pool car shocked at what I had just witnessed.

I called a manager from another service. This person showed care and compassion, talking me through the next steps, and following up with me a few days later, something the interim manager did not do. For me any relationship and or trust with the interim manager was gone, I would not go to them again with any future concerns.

The experience taught me the importance of the emotional attachment someone with a concern has, and that we should always ensure when individuals have the courage to speak up, that we give the support required and ask what matters to them.

Hopefully we all value the importance of developing our skills in supporting each other to raise any issues we have, and for those who hear concerns to truly listen, care, learn and act.

Caroline McDowall is a former podiatrist and Royal College of Podiatry TU and Health and Safety Rep. She is now Staff Wellbeing Lead and Speak Up Ambassador NHS Lothian